{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T03:44:37Z","timestamp":1793504677536,"version":"4.5.0"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2013,5,20]]},"abstract":"\n Background<\/jats:title>\n \n More accurate and reliable stroke risk prediction tools are needed to optimize anticoagulation decision making in patients with atrial fibrillation (\n AF<\/jats:styled-content>\n ). We developed a new\n AF<\/jats:styled-content>\n stroke prediction model using the original\n A<\/jats:styled-content>\n nticoagulation and\n R<\/jats:styled-content>\n isk\n F<\/jats:styled-content>\n actors in\n A<\/jats:styled-content>\n trial\n F<\/jats:styled-content>\n ibrillation (\n ATRIA<\/jats:styled-content>\n )\n AF<\/jats:styled-content>\n cohort and externally validated the score in a separate, contemporary, community\u2010based inception\n AF<\/jats:styled-content>\n cohort,\n ATRIA<\/jats:styled-content>\n \u2013\n C<\/jats:styled-content>\n ardiovascular\n R<\/jats:styled-content>\n esearch\n N<\/jats:styled-content>\n etwork (\n CVRN<\/jats:styled-content>\n ) cohort.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n The derivation\n ATRIA<\/jats:styled-content>\n cohort consisted of 10\u00a0927 patients with nonvalvular\n AF<\/jats:styled-content>\n contributing 32\u00a0609 person\u2010years off warfarin and 685 thromboembolic events (\n TE<\/jats:styled-content>\n s). The external validation\n ATRIA<\/jats:styled-content>\n \u2010\n CVRN<\/jats:styled-content>\n cohort included 25\u00a0306\n AF<\/jats:styled-content>\n patients contributing 26\u00a0263 person\u2010years off warfarin and 496\n TE<\/jats:styled-content>\n s. Cox models identified 8 variables, age, prior stroke, female sex, diabetes mellitus, heart failure, hypertension, proteinuria, and\n eGFR<\/jats:styled-content>\n <45\u00a0mL\/min per 1.73\u00a0m\n 2<\/jats:sup>\n or end\u2010stage renal disease, plus an age\u00d7prior stroke interaction term for the final model. Point scores were assigned proportional to model coefficients. The c\u2010index in the\n ATRIA<\/jats:styled-content>\n cohort was 0.73 (95%\n CI<\/jats:styled-content>\n , 0.71 to 0.75), increasing to 0.76 (95%\n CI<\/jats:styled-content>\n , 0.74 to 0.79) when only severe events were considered. In the\n ATRIA<\/jats:styled-content>\n \u2010\n CVRN<\/jats:styled-content>\n , c\u2010indexes were 0.70 (95%\n CI<\/jats:styled-content>\n , 0.67 to 0.72) and 0.75 (95%\n CI<\/jats:styled-content>\n , 0.72 to 0.78) for all events and severe events, respectively. The C\u2010index was greater and net reclassification improvement positive comparing the\n ATRIA<\/jats:styled-content>\n score with the\n CHADS<\/jats:styled-content>\n 2<\/jats:sub>\n or CHA\n 2<\/jats:sub>\n DS\n 2<\/jats:sub>\n \u2010VASc scores.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n The\n ATRIA<\/jats:styled-content>\n stroke risk score performed better than existing risk scores, was validated successfully, and showed improvement in predicting severe events, which is of greatest concern. The\n ATRIA<\/jats:styled-content>\n score should improve the antithrombotic decision for patients with\n AF<\/jats:styled-content>\n and should provide a secure foundation for the addition of biomarkers in future prognostic models.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.113.000250","type":"journal-article","created":{"date-parts":[[2013,6,19]],"date-time":"2013-06-19T23:56:20Z","timestamp":1371686180000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":347,"title":["A New Risk Scheme to Predict Ischemic Stroke and Other Thromboembolism in Atrial Fibrillation: The ATRIA Study Stroke Risk Score"],"prefix":"10.1161","volume":"2","author":[{"given":"Daniel E.","family":"Singer","sequence":"first","affiliation":[{"name":"Clinical Epidemiology Unit, Massachusetts General Hospital, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuchiao","family":"Chang","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Unit, Massachusetts General Hospital, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leila H.","family":"Borowsky","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Unit, Massachusetts General Hospital, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret C.","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of California San Francisco, San Francisco, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niela K.","family":"Pomernacki","sequence":"additional","affiliation":[{"name":"Division of Research, Kaiser Permanente of Northern California, Oakland, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Udaltsova","sequence":"additional","affiliation":[{"name":"Division of Research, Kaiser Permanente of Northern California, Oakland, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristi","family":"Reynolds","sequence":"additional","affiliation":[{"name":"Department of Research and Evaluation, Kaiser Permanente of Southern California, Pasadena, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan S.","family":"Go","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of California San Francisco, San Francisco, CA"},{"name":"Division of Research, Kaiser Permanente of Northern California, Oakland, CA"},{"name":"Department of Epidemiology, University of California San Francisco, San Francisco, CA"},{"name":"Department of Biostatistics, University of California San Francisco, San Francisco, CA"},{"name":"Department of Health Research and Policy, Stanford University School of Medicine, Palo Alto, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.22.8.983"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-131-7-199910050-00003"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1994.00420130036007"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.177292"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.10.001"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.11-2304"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eus305"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.285.22.2864"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.09-1584"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2010.04085.x"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.09.065"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-131-12-199912210-00004"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.290.20.2685"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.816082"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.19.5.604"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.553438"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.109.562017"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2004.07.056"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4757-3462-1"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.publhealth.20.1.145"},{"key":"e_1_3_3_22_2","volume-title":"Concordance for Survival Time Data: Fixed and Time\u2010Dependent Covariates and Possible Ties in Predictor and Time","author":"Kremers W","year":"2007","unstructured":"Kremers W. 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